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Subject:
From:
Judith Hayman <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 17 May 2005 08:23:10 -0400
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>Then there is all the conflicting advice.  Many moms 
>report that every  nurse told them something different 
>or that they saw 3 different lactation specialists in 
>the hospital, and they all said something different.

Oh, sigh.  There are several cautionary tales in this.

How well I recall my days in ER.  I take a very good history with lots
of details.  Then the doc comes in and gets COMPLETELY different
information. Literally, the client changes the story, or chooses to
emphasize different points.  The excruciating pain turns into a little
discomfort.  The slight wheeze becomes severe shortness of breath.  

So then the doc does an explanation about the problem and the treatment
plan to the patient (which I can hear being one curtain and three feet
away).  I go to implement that and the patient has it exactly
upside-down, inside out or whatever.  I remember the frustration very
well.  (Teaching point:  always use patient/client language, not
medspeak, and double check what you think YOU'VE heard from them, as
well as what they heard from you).

As Claire said, the important thing here is that the mom doesn't
necessarily process all of what was said, hears only what she wants to
hear, gets it confused with other information received, etc. Sometimes
she has it partly or exactly right and the other advice was weird.  I'm
very hesitant to dismiss someone's else's expertise out of hand.  Unless
the information was flat out wrong, often I'll say something like, "Well
that was one of the many options we could have taken, but that one
didn't work well, so let's move on to another one.  And if that doesn't
work, we've got still others".

I don't think it helpful to instil in someone the idea that they got
_bad_ care unless you're convinced it's true.  

(The client who was told to take 250 mg Amoxicillin three times a day
for an obvious mastitis was told by me and two others that this was just
plain wrong).

Judith

Judith Hayman, RN, IBCLC, BSc, BScN
Public Health Nurse & Lactation Consultant

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